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Room: E-Poster Hall

P-17.06 Role of sex in post-transplant diabetes mellitus development: Are men and women equal?

Ivana Dedinska, Slovakia (Slovak Republic)

Head of department
Transplant Nephrology Department
University hospital Martin and Jessenius Faculty of Medicine Comenius University

Abstract

Role of sex in post-transplant diabetes mellitus development: Are men and women equal?

Ivana Dedinska1, Matej Vnučák1, Karol Graňák1, Petra Skálová1, Ľudovít Laca1, Marián Mokáň2.

1Surgery clinic and Transplant center, University hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia (Slovak Republic); 2Internal department I, university hospital martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia (Slovak Republic)

Introduction and Aims: PTDM (posttransplant diabetes mellitus) development is influenced by several variables that are specific only to the transplanted population. Sex differences with regard to PTDM have not yet been published in any available study and therefore the objective of our multicentre prospective 12-month analysis was to determine whether risk factors for PTDM in patients after kidney transplantation (KT) are the same for women and men. 
This prospective multicentre analysis with 12-month follow-up included 417 patients without a diagnosis diabetes mellitus type 1 or 2 or prediabetes at the time of  KT were engaged in the analysis.  For the analysis of collected data, we divided the patients into four groups as follows: men – control group, men – PTDM, women – control group, and women – PTDM. We compared individual groups according to gender, in the case of numeric parameters we  assessed their development. We compared the 12-month survival of grafts among all four groups. PTDM was diagnosed according to the ADA criteria. oGTT was performed in 10-12 weeks after KT and 12 months after KT.
A total of 417 patients (271 men and 146 women) were included in the monitored group. Age at the time of KT more than 60 years [HR 2,2737; (P = 0.0268) – for men, HR 16,6250; (P = 0,0042) – for women] and hypovitaminosis D at the time of KT (<20 µg/l) [HR 4,7500; (P = 0.0005) – for men, HR 2,2500; (P = 0,0021) – for women] were identified as independent risk factors for PTDM in both men and women. We further confirmed as an independent risk factor for men a waist circumference at the time of KT >94 cm [HR 1,6842; (P = 0.0146)], C-peptide at the time of KT >5 ng/ml [HR 3,2995; (P = 0.0356)], HOMA-IR >2 [HR 3,3503; (P = 0.0358)] and triacylglycerols at the time of KT >1.7 mmol/l [HR 4,1386; (P = 0.0308)]. In case of women, the dominant factor was BMI at the time of KT more than 30 kg/m2 [HR 4,1667; (P = 0.0001)] and menopause at the time of KT [HR 4,1386; (P = 0.0308)].  Men with PTDM had significantly the worst graft survival, followed by women with PTDM. We recorded a significant decrease in the value of C-peptide in the group of women with PTDM, which is one of the most important findings in our analysis.

Conclusions: We confirmed that there are gender differences with regard to the development of PTDM after KT. Women show pancreas β cell dysfunction, whereas insulin resistance and metabolic syndrome are dominant in men. 

 

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